Pirate Head Posted October 26, 2003 Share Posted October 26, 2003 Was wondering if there are any Doctors out there who have eliminated a donor scar with grafts and/or excision, so that patient can shave his head? Link to comment Share on other sites More sharing options...
Pirate Head Posted October 26, 2003 Author Share Posted October 26, 2003 Was wondering if there are any Doctors out there who have eliminated a donor scar with grafts and/or excision, so that patient can shave his head? Link to comment Share on other sites More sharing options...
Guest Posted November 4, 2003 Share Posted November 4, 2003 You present a difficult, but not impossible problem. First, how wide is your current scar? Second, how many scars do you have? Third, how close do you want to shave your hair? Finally, what color is your hair vs your skin (how much contrast)? Can you provide a picture of your current condition? While it is impossible to perform any type of scar less donor harvest, even FUE, there are ways to minimize visibility. But first, I need to know where you are currently before I could recommend a possible approach to help you. Sincerely, Brad Limmer, MD/jac Dr. Limmer Link to comment Share on other sites More sharing options...
Regular Member Miami Posted November 7, 2003 Regular Member Share Posted November 7, 2003 HI Doc, I have one 3 inch scar on the side of the head with small areas of sparseness around the sutured areas as well. I am 4 months post op. The width of the scar is about 2-3 mm and in some spots around 3-5mm. I only had 400 grafts so I feel like this could be much smaller. I would also like to shave my head and am looking for similar results. Link to comment Share on other sites More sharing options...
Guest Posted November 12, 2003 Share Posted November 12, 2003 Being that you have only had one prior procedure, repairing your scar from something that is 3-5 mm in width down to approximately 1 mm in width should be able to be accomplished with straightforward conservative repair. At 1 mm in width you should be able to shave your hair quite close. If this width is still not acceptable, then you have three choices; 1.) You can transplant the scar. 2.) Break up the scar by using small punches followed by suturing these sites closed. This follows the tried and true principles that all cosmetic surgeons know; an irregular scar can go unnoticed. While I have not performed old style punch transplantation, when these sites were sewn up and healed, even a long row of them, the marks could go unnoticed even with the hair shaved close. The reason, irregularity. 3.) A good cosmetic tattoo artist can also camouflage a 1 mm scar to the point that it goes unnoted when the hair is shave close. But be careful and go with someone who understands what to do. Many tattoo artists don't understand the art of camouflage and tattoo the entire scar, creating a dark straight line, exactly what you don't want. Color and technique choices are critical when tattooing a scar. Brad Limmer, MD/jac Dr. Limmer Link to comment Share on other sites More sharing options...
Guest Posted November 12, 2003 Share Posted November 12, 2003 dr. limmer maybe i'm mistaken,but if tension was present the first time around stretching a scar isn't it safe to say that even more tension will be present the 2nd and subsequent times forcing more tension and stress on the sutured area.i've had 2 ht's,the second being 2 months ago and it seems that i'm healing exactly the same as 1st time around.my doc completely excised the old scar,as he went along the same suture line for round two. seems like fue would make the most sense to camouflage a scar. Link to comment Share on other sites More sharing options...
Guest Posted November 12, 2003 Share Posted November 12, 2003 Figsy: My response was specific for Miami's case: One prior surgery and the probability of tension is low, but definitely needs to be considered. In your case you will have more tension as you have now had 2 procedures. Both of which involved harvesting of hair for transplantation. Also, I have no idea how wide either of your original donor excisions were. If they were wider than 1-1.2 cm the chance of tension was significant. In addition, when working over the mastoid you have to be careful and frequently excise narrower. In Miami's case I would only be removing the scar with minimal surrounding hair/skin. Therefore, the excision width would be much narrower than I suspect yours was. You not only had scar removal but donor hair was harvested for transplantation. Also, where your old scar was located with regards to the excision (top margin, bottom margin or dead center) can make a huge difference when it comes to how much tension is present at the time of closure. In order to minimize tension on subsequent excisions you must remove not only the visible scar, but also all the underlying scar tissue the can bind the scalp down causing an unexpected tight closure. Each case is different and needs to be approached on an individual basis. Brad Limmer, MD/jac Dr. Limmer Link to comment Share on other sites More sharing options...
Guest Posted November 19, 2003 Share Posted November 19, 2003 I fully understand your situation but you mention you had a transplant of only 400 grafts? What is with that? That is unethical. Did he not inform you that scars are at most perm and that you cannot shave your head? I'm just a little confused Matthew Link to comment Share on other sites More sharing options...
Regular Member Miami Posted November 22, 2003 Regular Member Share Posted November 22, 2003 Dr Limmer. Thanks for your reply. Do you have any suggestions on a doctor I could see to have this procedure done? I find the comments on irregularity very interesting and seem to make sense. I also have some spotted scars below and above the scar line from the sutures. The scars are also still slightly red/pink after 4 months. Do you think it's ok to go through with a procedure to repair the scar at this period or should more time elapse? matthew: Unethical? Yes I believe so now looking back, a mistake on my part and something I regret looking back. I went to a hair mill, they showed me scar examples which I know now are only best case scenarios. Nothing I can do now but look forwards and try to make sure my decisions to repair what has happened are well researched Link to comment Share on other sites More sharing options...
Guest Posted November 25, 2003 Share Posted November 25, 2003 Miami: In your area you might want to visit with Paul Rose or Jeffrey Epstein. I would also allow a little more time for a scar maturation, at least another 3-4 months. Scars can take over 1 year to fully mature and pending exam, it might be best to wait a full year. Brad Limmer, MD/jac Dr. Limmer Link to comment Share on other sites More sharing options...
Regular Member Miami Posted November 26, 2003 Regular Member Share Posted November 26, 2003 Hi Dr Limmer, thanks for the help. Do you mean that I have to wait another 3-4 months for scar revision and then possible another 12 months on top of that before attempting to FUE/FIT into the scar (or are you referring to FUE/FIT process?). I was originally hoping to revise the scar over the next few months and then attempt FUE/FIT around 1 year or so after the revision depending on healing. I am noticing many posts claiming that the older the scar, the better the chance of FIT/FUE growing in that scar (though this seems to be based on theory only at this point). This might suggest the 1 year period after the revision might also be too soon. If both are right, then I might be looking at (3-4 months of original scar healing) + (1 year revised scar healing) + (6 months for FUE/FIT to regrow) = 2 years before I can fix things The location of the scar makes it very difficult to hide and is really affecting my lifestyle in a negative way but I know that things should not be rushed, I just can't wait to get back to a more normal life that I remember. Link to comment Share on other sites More sharing options...
Guest Posted December 3, 2003 Share Posted December 3, 2003 Miami: My answer is ??YES' because I recommend being conservative. However, I have never been able to evaluate you in person and pending exam you might be able to proceed with a faster timeline. Remember, it is better to proceed slowly. You have your whole life in front of you and you want this done right. Brad Limmer, MD/jac Dr. Limmer Link to comment Share on other sites More sharing options...
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